26 February 2019 In Drinking & Eating Patterns

Background: Alcohol-induced hangover constitutes a significant, yet understudied, global hazard and a large socio-economic burden. Old folk wisdoms such as "Beer before wine and you'll feel fine; wine before beer and you'll feel queer" exist in many languages. However, whether these concepts in fact reduce hangover severity is unclear.

Objectives: The aim of this study was to investigate the influence of the combination and order of beer and wine consumption on hangover intensity. Methods: In this multiarm, parallel randomized controlled matched-triplet crossover open-label interventional trial, participants were matched into triplets and randomly assigned according to age, gender, body composition, alcohol drinking habits, and hangover frequency. Study group 1 consumed beer up to a breath alcohol concentration (BrAC) >/=0.05% and then wine to BrAC >/=0.11% (vice versa for study group 2). Control group subjects consumed either only beer or only wine. On a second intervention day (crossover) >/=1 wk later, study-group subjects were switched to the opposite drinking order. Control-group subjects who drank only beer on the first intervention received only wine on the second study day (and vice versa). Primary endpoint was hangover severity assessed by Acute Hangover Scale rating on the day following each intervention. Secondary endpoints were factors associated with hangover intensity.

Results: Ninety participants aged 19-40 y (mean age 23.9), 50% female, were included (study group 1 n = 31, study group 2 n = 31, controls n = 28). Neither type nor order of consumed alcoholic beverages significantly affected hangover intensity (P > 0.05). Multivariate regression analyses revealed perceived drunkenness and vomiting as the strongest predictors for hangover intensity.

Conclusions: Our findings dispel the traditional myths "Grape or grain but never the twain" and "Beer before wine and you'll feel fine; wine before beer and you'll feel queer" regarding moderate-to-severe alcohol intoxication, whereas subjective signs of progressive intoxication were confirmed as accurate predictors of hangover severity. This trial was prospectively registered at the Witten/Herdecke University Ethics Committee as 140/2016 and retrospectively registered at the German Clinical Trials Register as DRKS00015285

 

Reference/Source

Kochling,J.; Geis,B.; Wirth,S.; Hensel,K.O.

Grape or grain but never the twain? A randomized controlled multiarm matched-triplet crossover trial of beer and wine

Am.J Clin.Nutr, 2019, 109,2: 345-352.

27 September 2018 In Drinking & Eating Patterns

BACKGROUND AND AIMS: Studies examining the next-day cognitive effects of heavy alcohol consumption have produced mixed findings, which may reflect inconsistencies in definitions of 'hangover'. Recent consensus has defined hangover as 'mental and physical symptoms, experienced the day after a single episode of heavy drinking, starting when blood alcohol concentration (BAC) approaches zero'. In light of this, we aimed to review the literature systematically to evaluate and estimate mean effect sizes of the next-day effects of heavy alcohol consumption on cognition.

METHODS: Embase, PubMed and PsycNET databases were searched between December 2016 and May 2018 using terms based on 'alcohol' and 'hangover'. Studies of experimental designs which reported the next-day cognitive effects of heavy alcohol consumption in a 'hangover' group with BAC < 0.02% were reviewed. A total of 805 articles were identified. Thirty-nine full-text articles were screened by two independent reviewers and 19 included in the systematic review; 11 articles provided sufficient data to be included in the meta-analysis; 1163 participants across 19 studies conducted since 1970 were included in the analysis. Data for study design, hangover severity, BAC at testing and cognitive performance were extracted and effect estimates calculated.

RESULTS: The systematic review suggested that sustained attention and driving abilities were impaired during hangover. Mixed results were observed for: psychomotor skills, short- (STM) and long-term memory (LTM) and divided attention. The meta-analysis revealed evidence of impairments in STM [g = 0.64, 95% confidence interval (CI) = 0.15-1.13], LTM (Hedges' g = 0.59, 95% CI = 0.01-1.17) sustained attention (g = 0.47, 95% CI = 0.07-0.87) and psychomotor speed (Hedges' g = 0.66, 95% CI = 0.31-1.00) during alcohol hangover.

CONCLUSION: The research literature suggests that alcohol hangovers may involve impaired cognitive functions and performance of everyday tasks such as driving.

22 June 2017 In General Health

INTRODUCTION: Energy drinks are popular beverages that are supposed to counteract sleepiness, increase energy, maintain alertness and reduce symptoms of hangover. Cognitive enhancing seems to be related to many compounds such as caffeine, taurine and vitamins. Currently, users mostly combine psychostimulant effects of energy drinks to counteract sedative effects of alcohol. However, recent literature suggests that this combination conducts to feel less intoxicated but still impaired. The goal of the present article is to review cognitive impact and subjective awareness in case of caffeinated alcoholic beverage (CAB) intoxication.

METHOD: PubMed (January 1960 to March 2016) database was searched using the following terms: cognitive impairments, alcohol, energy drinks; cognition, alcohol, caffeine.

RESULTS: 99 papers were found but only 12 randomized controlled studies which explored cognitive disorders and subjective awareness associated with acute CAB or AED (alcohol associated with energy drinks) intoxication were included.

DISCUSSION: The present literature review confirmed that energy drinks might counteract some cognitive deficits and adverse effects of alcohol i.e. dry mouth, fatigue, headache, weakness, and perception of intoxication due to alcohol alone. This effect depends on alcohol limb but disappears when the complexity of the task increases, when driving for example. Moreover, studies clearly showed that CAB/AEDs increase impulsivity which conducts to an overconsumption of alcohol and enhanced motivation to drink compared to alcohol alone, potentiating the risk of developing addictive behaviors. This is a huge problem in adolescents with high impulsivity and immature decision making processes.

CONCLUSION: Although energy drinks counteract some cognitive deficits due to alcohol alone, their association promotes the risk of developing alcohol addiction. As a consequence, it is necessary to better understand the neurobiological mechanisms underlying these interactions in order to better prevent the development of alcohol dependence.

AIMS: To test whether (i) drinking motives predict the frequency of pre-drinking (i.e. alcohol consumption before going out); (ii) drinking motives predict HDGE (heavy drinking on a given evening: 4+ for women, 5+ for men) and related adverse consequences (hangover, injuries, blackouts, etc.), even when pre-drinking is accounted for, and (iii) drinking motives moderate the impact of pre-drinking on HDGE and consequences.

DESIGN: Using the internet-based cellphone-optimized assessment technique (ICAT), participants completed a series of cellphone questionnaires every Thursday, Friday and Saturday evening over 5 weeks.

SETTING: French-speaking Switzerland.

PARTICIPANTS: A total of 183 young adults [53% female, mean age (standard deviation) = 23.1 (3.1)] who completed 7828 questionnaires on 1441 evenings.

MEASUREMENTS: Drinking motives assessed at baseline, alcohol consumption assessed at 8 p.m., 9 p.m., 10 p.m., 11 p.m. and midnight and consequences assessed at 11 a.m. the next day.

FINDINGS: Gender-separate multi-level models revealed that pre-drinking predicted HDGE (men: B = 2.17, P < 0.001; women: B = 2.12, P < 0.001) and alcohol-related consequences (men: B = 0.24, P < 0.01; women: B = 0.29, P < 0.001). Enhancement motives were found to predict HDGE (B = 0.48, P < 0.05) and related consequences (B = 0.09, P < 0.05) among men, while among women coping motives had the same effect (HDGE: B = 0.73, P < 0.001; consequences: B = 0.13, P < 0.01). With the exception of conformity motives among women (B = 0.54, P < 0.05), however, no drinking motive dimension predicted the frequency of pre-drinking, while coping and conformity motives moderated the impact of pre-drinking on HDGE (men, conformity: B = -1.57, P < 0.05) and its consequences (men, coping: B = -0.46, P < 0.01; women, coping: B = 0.76, P < 0.05).

CONCLUSIONS: Among young adults in Switzerland, heavy weekend drinking and the related consequences seem to result from the combination of pre-drinking, level of negative reinforcement drinking for women and positive reinforcement drinking for men.

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